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PART V (B) Form GHSP-D-03 <br /> I <br /> y ACCEPTANCE OF CONDITIONS <br /> This application is approved for fiscal year <br /> highway safety project is granted subject to the State and Federal laws and regu t proceed with this <br /> the North Carolina Governor's Highway Safety Program and the conditions stated elowpplicable to <br /> 1. Unless otherwise directed, applicants must submit <br /> which reflect the status of project implementation and attainment Progress stated Reports al Each progress <br /> ro GHSP <br /> report shall describe the project status quarterly and shall be submitted to GHSP no later than <br /> fifteen(15)days subsequent to the termination of each quarter.A Final Accomplishment p 4 ess <br /> (Form GHSP-D-10)must be submitted to the GHSP within thirty <br /> Report <br /> project unless otherwise directed. Appropriate forms will be mai30d to days oject completion l the a reminder notice advising date that each is due. <br /> 2. Applicants making purchases or entering into contracts as provided for by this project must <br /> adhere to the policies and procedures of Attachment 0 of OMB Circular A-102 or A-110 <br /> whichever is applicable. <br /> 3. All Out-of-State travel must have prior approval I <br /> Requests for approval (Form GHSP-A-17) should bet submitted to GHSP at least Safety(2r weak. <br /> before the intended date of travel. - ) eeks <br /> 4. Applicants must submit any proposed agreements for contractual services to the Gove <br /> Highway Safety Program for final approval prior to acceptance. roar's <br /> 5. Applicants shall account for program income related to projects financed in whole or in part <br /> with federal funds in accordance with Attachment E of OMB Circular A-102 or Attachment D of <br /> OMB Circular A-110, whichever is applicable. Program income earned during the contract <br /> period shall be retained by the applicant and added to the.funds committed to the project by the <br /> GHSP and be used to further eligible program objectives. <br /> C. Local government applicants must complete Attachment 1 entitled "Local Governmental <br /> Resolution". <br /> 7. Any continuation of this project with funds from the State of North Carolina is contingent u <br /> State funds being appropriated by the General Assembly specifically for that purpose. p°n <br /> PROJECT DIRECTOR Read the above"Conditions"before si•nin• <br /> NAME <br /> Mary Babbitt—Cooke TITLE ADDRESS <br /> /IG_NATURE Health Promotion Coordinator ..P.TELEPHONE 8181 Hi11sb• .0 7h7NC <br /> TELEPHONE NUMBER <br /> Ext� 305 <br /> AUTHO-IZING OFFICIAL OF GOVERNMENTAL UNIT Read the above"Conditions,before s1•nin. <br /> NAME <br /> TITLE ADDRESS <br /> Daniel B. Reimer <br /> SIGNATURE ',,, +- e t•-,- H-- 1 • _ <br /> MEPNONE NUMBER <br /> OFFICIAL OF GOVERNMENTAL UNIT AUTHORIZED TO RECEIVE FUNDS UNDER THIS PROJECT t 5 <br /> 1 <br /> ADDRESS <br /> ORGANIZATION <br /> APPROVAL INFORMATION FOR GHSP USE ONLY <br /> APPROVAL DATE <br />